{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:02:49Z","timestamp":1790182969126,"version":"4.1.0"},"reference-count":21,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Civil Aviation Safety Capacity Building Project","award":["2024-164"],"award-info":[{"award-number":["2024-164"]}]},{"name":"Civil Aviation Safety Capacity Building Project","award":["FB2025015"],"award-info":[{"award-number":["FB2025015"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,3]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the prevalence and anatomical distribution of work-related musculoskeletal disorders (WMSDs) among pilots of a Chinese commercial airline and identify factors associated with neck, shoulder and lower-back WMSDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A commercial airline in China; data were collected during routine periodic medical examinations from 17 November 2025 to 31 December 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 1042 active commercial airline pilots (1030 men and 12\u2009women) were included from 1200 invited pilots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The prevalence of WMSDs across nine anatomical regions and factors associated with WMSDs in the neck, shoulders and lower back.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of WMSDs was 21.50%; the most commonly affected regions were the lower back (11.52%), neck (11.32%) and shoulders (8.35%). Working in uncomfortable postures was associated with WMSDs across all three regions, particularly for \u2018often\u2019 exposure: neck (adjusted OR (aOR) 7.97, 95%\u2009CI 3.58 to 17.76), shoulders (aOR 5.48, 95%\u2009CI 2.35 to 12.80)\u2009and lower back (aOR 8.58, 95%\u2009CI 3.89 to 18.94). Neck WMSDs were associated with prolonged head-down posture and covering shifts for colleagues, whereas adequate rest time was inversely associated. Shoulder WMSDs were associated with prolonged static back posture. Lower-back WMSDs were positively associated with covering shifts and cold\/temperature exposure and inversely associated with adequate rest, daily task variation and outdoor work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>WMSDs most commonly affected the lower back, neck and shoulders. Working in uncomfortable postures was consistently associated with WMSDs across these regions, while work-organisation and environmental factors showed site-specific associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-123382","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:12:48Z","timestamp":1790179968000},"page":"e123382","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Region-specific prevalence and associated factors of work-related musculoskeletal disorders among pilots of a commercial airline: a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3503-5123","authenticated-orcid":false,"given":"Tiebing","family":"Liu","sequence":"first","affiliation":[{"name":"Civil Aviation Public Health Emergency Management Office, Civil Aviation Medicine Center, Civil Aviation Administration of China(Civil Aviation General Hospital), Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5150-9819","authenticated-orcid":false,"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Civil Aviation Public Health Emergency Management Office, Civil Aviation Medicine Center, Civil Aviation Administration of China(Civil Aviation General Hospital), Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6974-3961","authenticated-orcid":false,"given":"Jiajian","family":"Pan","sequence":"additional","affiliation":[{"name":"Health Management Department, Xiamen Airlines Co., Ltd, Xiamen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8587-3127","authenticated-orcid":false,"given":"Yanmin","family":"Qi","sequence":"additional","affiliation":[{"name":"Civil Aviation Public Health Emergency Management Office, Civil Aviation Medicine Center, Civil Aviation Administration of China(Civil Aviation General Hospital), Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"2026092309103355000_16.9.e123382.1","unstructured":"Musculoskeletal health. World Health Organization; 2022. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/musculoskeletal-conditions"},{"key":"2026092309103355000_16.9.e123382.2","unstructured":"About Ergonomics and Work-Related Musculoskeletal Disorders. National Institute for Occupational Safety and Health (NIOSH), the Centers for Disease Control and Prevention; 2024. Available: https:\/\/www.cdc.gov\/niosh\/ergonomics\/about\/index.html [Accessed 20 May 2026]."},{"key":"2026092309103355000_16.9.e123382.3","unstructured":"Step 1: identify risk factors. National Institute for Occupational Safety and Health (NIOSH), the Centers for Disease Control and Prevention; 2024. Available: https:\/\/www.cdc.gov\/niosh\/ergonomics\/ergo-programs\/risk-factors.html [Accessed 20 May 2026]."},{"key":"2026092309103355000_16.9.e123382.4","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20750"},{"key":"2026092309103355000_16.9.e123382.5","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.46234\/ccdcw2022.227","article-title":"Incidence and Risk Factors of the Upper-Limb Musculoskeletal Disorders Among Occupational Groups in Key Industries - China, 2018-2021","volume":"4","author":"Jia","year":"2022","journal-title":"China CDC Wkly"},{"key":"2026092309103355000_16.9.e123382.6","first-page":"1388","article-title":"Prevalence and Risk Factors of Lower Extremity Musculoskeletal Disorders Among Occupational Groups in Key Industries - China, 2018-2023","volume":"6","author":"Jia","year":"2024","journal-title":"China CDC Wkly"},{"key":"2026092309103355000_16.9.e123382.7","doi-asserted-by":"crossref","first-page":"879","DOI":"10.3357\/ASEM.3044.2011","article-title":"Prevalence of and biopsychosocial factors associated with low back pain in commercial airline pilots","volume":"82","author":"Prombumroong","year":"2011","journal-title":"Aviat Space Environ Med"},{"key":"2026092309103355000_16.9.e123382.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-013-0911-8"},{"key":"2026092309103355000_16.9.e123382.9","doi-asserted-by":"crossref","first-page":"795","DOI":"10.3357\/AMHP.4384.2016","article-title":"Characterization of Low Back Pain in Pilots and Maintenance Technicians on a Commercial Airline","volume":"87","author":"Fajardo Rodriguez","year":"2016","journal-title":"Aerosp Med Hum Perform"},{"key":"2026092309103355000_16.9.e123382.10","doi-asserted-by":"crossref","first-page":"940","DOI":"10.3357\/AMHP.5656.2020","article-title":"Low Back Pain in Commercial Airline Pilots","volume":"91","author":"Albermann","year":"2020","journal-title":"Aerosp Med Hum Perform"},{"key":"2026092309103355000_16.9.e123382.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-025-08405-5","article-title":"In the captain\u2019s chair: a cross-sectional study on back pain among commercial airline pilots in Saudi Arabia","volume":"26","author":"AlMuammar","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"key":"2026092309103355000_16.9.e123382.12","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2023.1226930","article-title":"Prevalence and risk factors of occupational neck pain in Chinese male fighter pilots: a cross-sectional study based on questionnaire and cervical sagittal alignment","volume":"11","author":"Yang","year":"2023","journal-title":"Front Public Health"},{"key":"2026092309103355000_16.9.e123382.13","doi-asserted-by":"crossref","first-page":"744601","DOI":"10.3389\/fpubh.2021.744601","article-title":"Prevalence and Potential Risk Factors for Occupational Low Back Pain Among Male Military Pilots: A Study Based on Questionnaire and Physical Function Assessment","volume":"9","author":"Yang","year":"2022","journal-title":"Front Public Health"},{"key":"2026092309103355000_16.9.e123382.14","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(87)90010-X"},{"key":"2026092309103355000_16.9.e123382.15","doi-asserted-by":"publisher","DOI":"10.1080\/00140130110087437"},{"key":"2026092309103355000_16.9.e123382.16","first-page":"335","article-title":"The assessment of reliability and validity of musculoskeletal questionnaire","volume":"30","author":"Du","year":"2012","journal-title":"Chin J Ind Hyg Occup Dis"},{"key":"2026092309103355000_16.9.e123382.17","first-page":"25","article-title":"Study on musculoskeletal disease questionnaire","volume":"35","author":"Yang","year":"2009","journal-title":"Ind Health Occup Dis"},{"key":"2026092309103355000_16.9.e123382.18","first-page":"27","article-title":"Reliability and validity of Chinese version Musculoskeletal Questionnaire in shipbuilding industry","volume":"34","author":"Zhang","year":"2017","journal-title":"J Environ Occup Med"},{"key":"2026092309103355000_16.9.e123382.19","doi-asserted-by":"crossref","unstructured":"Salvendy G , ed. 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Report No: DHHS (NIOSH) Publication No. 97\u2013141; 1997."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-123382","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:12:52Z","timestamp":1790179972000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-123382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,23]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjopen-2026-123382"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-123382","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}